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2 MSK > Muscle Diseases > Flashcards

Muscle Diseases Flashcards

1
Q

how do muscles diseases typically present?

A

myalgia
muscle weakness
stiffness
abnormal bloods

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2
Q

name the 2 inflammatory myopathies

A

polymyositis

dermatomyositis

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3
Q

most common age to be affected by an inflammatory myopathy

A

40-50 years

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4
Q

features of inflammatory myopathies on muscle biopsy

A

muscle fibre necrosis
degeneration
regeneration
inflammatory cell infiltrate

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5
Q

is muscle weakness usually symmetrical or asymmetrical?

A

symmetrical

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6
Q

what is gottrons sign

A

symmetric, occasionally scaling, violaceous erythematous eruption over the extensor surfaces of the metacarpophalangeal and interphalangeal joints of the fingers

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7
Q

which muscle disease is associated with a heliotype rash?

A

dermatomyositis

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8
Q

GI effects of dermatomyositis

A

dysphagia

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9
Q

CV effects of dermatomyositis

A

myocarditis

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10
Q

lung effects of dermatomyositis

A

ILD

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11
Q

which muscle disease is most likely to get malignancy?

A

dermatomyositis

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12
Q

most common malignancies to arise in muscle disease

A 
ovarian
breast
stomach
lung
bladder
colon
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13
Q

presenting symptoms of dermatomyositis

A 
tired muscles
functional difficulty
raynauds
weight loss
cough
breathlessness
muscle pain
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14
Q

what is confrontational testing?

A

direct testing of power eg pushing arm down while they resist

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15
Q

what is isotonic testing

A

30 sec sit to stand test

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16
Q

blood tests used in polymyositis?

A

CK
inflammatory markers
electrolytes, calcium, PTH, TSH
ANA, Anti-Jo-1

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17
Q

what is CK

A

a muscle enzyme

18
Q

what is electromyography

A

increasing fibrillations, abnormal motor potentials, complex repetitive discharges

19
Q

diagnostic techniques for myositis

A

muscle biopsy
MRI
EMG

20
Q

treatment for myositis

A

glucocorticoids
azathioprine
methotrexate

21
Q

most common misdiagnosis for inclusion body myositis

A

polymyositis

22
Q

presenting feature of inclusion body myositis

A

distal muscle weakness

23
Q

why is inclusion body myositis called this?

A

inclusion bodies on biopsy

24
Q

are CK levels higher in inclusion body myositis or polymyositis

A

polymyositis

25
Q

age group affected by polymyalgia rheumatica?

A

over 50s

26
Q

which areas of the world most commonly get it

A

northern countries

27
Q

what disease is polymyalgia rheumatica commonly associated with?.

A

temporal arteritis/giant cell arteritis

28
Q

clinical presentation of polymyalgia rheumatica

A

morning stiffness that improves throughout the day
ache in shoulder/hip
symmetrical
“cant get out of bed”

29
Q

clinical presentation of the arteritis that follows polymyalgia rheumatica

A

headache
scalp tenderness
jaw claudication
visual loss (if optic artery damaged)

30
Q

does inclusion body myositis affect the distal muscles?

A

yes

31
Q

does polymyositis affect the distal muscles

A

no, affects proximal

32
Q

which inflammatory markers are raised in polymyalgia rheumatica

A

raised ESR, plasma viscosity, CRP

33
Q

treatment of PMR?

A

very good reaction to low dose steroids

if arteritis, higher dose

34
Q

who commonly gets fibromyalgia

A

women of child bearing age

35
Q

what causes fibromyalgia

A

depression

stress

36
Q

clinical presentation of fibromyalgia

A 
muscle stiffness
pain
muscle tension
fatigue
trouble sleeping
chest pain
headache
cognitive difficulty
worse on exertion
37
Q

what pathogenic processes occur in fibromyalgia

A

hypersensitivity to pain

38
Q

associated conditions to fibromyalgia

A

depression

IBS

39
Q

treatment for myalgia

A

antidepressants
strong analgesics eg gabapentin, pregabalin, mild opiates
physio/OT/cognitive behavioural therapy

40
Q

elderly man with heavy feeling in arms struggling to climb stairs with a high CK

A

polymyositis

2 MSK (61 decks)

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